바로가기메뉴

본문 바로가기 주메뉴 바로가기

ACOMS+ 및 학술지 리포지터리 설명회

  • 한국과학기술정보연구원(KISTI) 서울분원 대회의실(별관 3층)
  • 2024년 07월 03일(수) 13:30
 

logo

부적응적 완벽주의와 만성피로의 관계: 우울과 불안의 매개효과

The relationship between Maladaptive Perfectionism and Fatigue: the Mediating role of Depression and Anxiety

한국심리학회지: 건강 / The Korean Journal of Health Psychology, (P)1229-070X; (E)2713-9581
2015, v.20 no.1, pp.139-159
https://doi.org/10.17315/kjhp.2015.20.1.008
임경혜 (위드병원 정신건강의학과)
심은정 (부산대학교)
  • 다운로드 수
  • 조회수

초록

본 연구는 피로와 부적응적 완벽주의, 우울 및 불안의 관계를 살펴보고, 우울과 불안이 부적응적 완벽주의와 피로와의 관계를 매개하는 지를 검증하였다. 이를 위해 대구/경북지역에 거주하는 총 491명을(직장인 239명, 대학생 252명) 대상으로 부적응적 완벽주의 척도 (Multidimensional Perfectionism Scale), 피로척도(Fatigue Scale), 우울(BDI) 및 불안(BAI) 척도를 실시하였다. 주요 결과는 다음과 같다. 첫째, 부적응적 완벽주의와 피로는 유의한 정적 상관을 보여, 부적응적 완벽주의가 높을수록 피로의 수준이 높은 것으로 나타났다. 둘째, 부적응적 완벽주의가 높을수록 우울감과 불안감이 높은 것으로 나타났다. 셋째, 우울감과 불안감이 높을수록 피로의 수준이 높은 것으로 나타났다. 넷째, 우울은 부적응적 완벽주의와 피로와의 관계를 매개하였고, 불안은 부분 매개하는 것으로 나타났다. 마지막으로, 우울과 불안이 공존하는 경우 피로와 부적응적 완벽주의의 관계를 직선매개하는 것으로 나타났고, 불안은 우울을 매개하여 순차적으로 피로에 영향을 미치는 것으로 나타났다. 본 연구의 결과는 부적응적 완벽주의가 피로에 영향을 미치는 과정에서 우울과 불안이 매개함을 검증하여, 만성피로의 평가와 치료에서 완벽주의와 우울과 불안 등의 심리적 요인에 대한 평가와 개입이 필요함을 시사한다.

keywords
부적응적 완벽주의, 피로, 우울, 불안, Maladaptive Perfectionism, Fatigue, Depression, Anxiety

Abstract

The purpose of the study was to examine the relationship between maladaptive perfectionism and the fatigue, and the mediating role of the depression and anxiety in their relationship. A total of 491 participants (252 university students and 239 employees) in Daegu/Kyongbuk area participated in the study. Participants completed the fatigue(Fatigue Scale), maladaptive perfectionism (Multidimensional Perfectionism: FMPS), and depression and anxiety (BDI and BAI). Major findings of the study were the following. First, maladaptive perfectionism and the fatigue showed a significant positive correlation. Secondly, maladaptive perfectionism showed a significant positive correlation with depression and anxiety. Thirdly, depression and anxiety were significantly and positively correlated with fatigue. Fourthly, while depression fully mediated the relationship between maladaptive perfectionism and the fatigue, anxiety partially mediated. As the level of maladaptive perfectionism increases, so does the level of depression and anxiety, which in turn increases the level of fatigue. Lastly, in case of the comorbidity of anxiety and depression, it completely mediated the relationship between maladaptive perfectionism and fatigue. The current findings suggest that psychological factors like maladpative perfectionism, anxiety and depression should be considered in the evaluation and treatment of fatigue.

keywords
부적응적 완벽주의, 피로, 우울, 불안, Maladaptive Perfectionism, Fatigue, Depression, Anxiety

참고문헌

1.

건강보험심사평가원 (2009). 현대인의 질병, 만성피로증후군 환자 증가 추세. http://www.hira.or.kr/

2.

김광수 (2011). 간질환자에서 불안증과 우울증에 대한피로의 관계. 고신대학교의과대학 학술지, 26, 55-58.

3.

김윤희, 서수균 (2008). 완벽주의에 대한 고찰: 평가와치료. 한국심리학회지: 상담 및 심리치료, 20(3), 581-613.

4.

김중술, 육성필(1997). 한국판Beck anxiety inventory 의임상적 연구. 한국심리학회지: 임상, 16, 185-197.

5.

김현정, 손정락 (2007). 평가염려 완벽주의와 불안 및우울간의 관계에서 스트레스와 반복사고의 매개효과. 한국심리학회지 일반, 26(2), 183-205.

6.

김혜령 (1995). 혈액투석 환자의 피로와 관련 요인에 관한 연구. 대한간호학회지, 34(5), 47-51.

7.

김철환, 신호철 (1998). 만성피로 및 만성피로증후군 환자들의 임상적 특성. 가정의학회지, 19, 1354-1367.

8.

김철환, 신호철, 박용우 (2000). 만성피로 및 만성피로증후군의 유병률. 가정의학회지, 21(10), 1288-1298.

9.

박경 (2004). 부정적 생활스트레스와 우울과의 관계: 문제해결과 완벽주의의 중재 효과와 매개효과. 한국심리학회: 건강, 9, 265-283.

10.

박기흠 (1996). 만성피로. 가정의학회지, 17(4), 19-23.

11.

신호철 (2001). 만성 피로 증후군의 개요. 가정의학회지, 22(12), 1717-1742.

12.

신호철, 최창진, 송상욱, 최환석 (1993). 가정의학과 외래에 피로를 주소로 내원한 환자분석. 가정의학회지, 14(12), 833-842.

13.

이상엽, 김윤진 (2000). 중년 직장 남성의 피로 관련인자. 가정의학회지, 21(10), 1277-1287.

14.

이영호, 송종용 (1991), BDI, SDS, MMPI-D 척도의 신뢰도 및 타당도에 대한 연구. 한국심리학회지: 임상, 10(1), 98-113.

15.

오미경(1990). 건강검진자에서의 만성피로감에 대한 고찰, 가정의학회지, 11(4), 12-19.

16.

유상미 (2008), 대학생의 스트레스, 부적응적 완벽주의, 자살사고 간의 관계: 사회적 문제해결능력과 애착유형의 조절 효과 중심으로. 한국심리학회지: 학교, 5(2), 119-136.

17.

조용래, 김정호 (2002), 한국판 Beck Depression Inventory의 확인적 요인분석. 한국심리학회지: 임상, 21(4), 843-857.

18.

한기연(1993). 다차원적 완벽성-개념, 측정 및 부적응과의 관련성. 고려대학교 박사학위논문.

19.

한은경, 조용래, 박상학, 김학렬, 김상훈(2003). 한국판Beck Anxiety Inventory의 요인구조. 한국심리학회지: 임상, 22, 261-270.

20.

현진원 (1992). 완벽주의 성향과 평가수준이 과제수행에미치는 영향. 연세대학교 석사학위청구논문.

21.

홍세희 (2001). 임상심리학 이론의 경험적 검증을 위한최신 연구 방법론: 구조방정식 모형을 이용한 매개모형과 잠재평균 모형의 분석. 한국임상심리학회3월 워크샵 자료집.

22.

Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561.

23.

Beck, A., Epstein, N., Brown, G., & Steer R.A.(1988). An Inventory for Measuring Clinical Anxiety:Psychometric Properties. Journal of Consulting and Clinical Psychology, 56, 893-897.

24.

Centers for Disease Control and prevention(1994). Chronic Fatigue Syndrome, The 1994 Case Definition, http://www.cdc.gov/cfs/case-definition/1994.html

25.

Centers for Disease Control and prevention(2013). Chronic Fatigue Syndrome: A toolkit for providers, http://www.cdc.gov/cfs/pdf/cfs-toolkit.pdf

26.

Chalder, T., Berelowitz, G., Pawlikowska, T., Watts, L., Wessely, S.,Wright, D., & Wallace, E. (1993). Development of a fatigue scale. Journal of Psychosomatic Research, 37, 147-153.

27.

Chang, E. C. (2002). Examining the link between perfectionism and psychological maladjustment:Social problem solving as a buffer. Cognitive Therapy and Research, 26(5), 581-595.

28.

Cheng, S. K. (2001). Life stress, problem solving, perfectionism, and depressive symptoms in Chinese. Cognitive Therapy and research, 25, 303-310.

29.

Creswell, C., & Chalder, T.(2001). Defensive coping styles in chronic fatigue syndrome. Journal of Psychosomatic Research, 51(4), 607-10.

30.

Deary, V., & Chalder, T. (2010). Personality and perfectionism in chronic fatigue syndrome: A closer look. Psychology and Health, 25(4), 465-475.

31.

Dittner, A. J., Rimes, K., & Thorpe, S. (2011). Negative perfectionism increases the risk of fatigue following a period of stress, Psychology and Health, 26(3), 253-268.

32.

Enns, M.W., Cox, B.J., & Clara, I. (2002). Adaptive and maladaptive perfectionism: developmental origins and association with depression proneness, Personality and Individual Differences, 33(6), 921-935.

33.

Epstein, K.R. (1995). The chronically fatigued patient, Medical Clinics of North America, 79, 315-27.

34.

Flett, G.L., Greene, A., & Hewitt, P.L. (2004). Dimensions of perfectionism and anxiety sensitivity. Journal of Rational-Emotive &Cognitive-Behavior Therapy, 22(1), 39-57.

35.

Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14(5), 449-468.

36.

Fuller-Thomson, E., & Nimigon, J.(2008). Factors associated with depression among individuals with chronic fatigue syndrome: findings from a nationally representative survey, Family Practice, 25(6), 414-422.

37.

Grzegorek, J. L.,Slaney, R. B., Franze, S., Rice, K. G. (2004). Self-Criticism, Dependency, Self-Esteem, and Grade Point Average Satisfaction Among Clusters of Perfectionists and Nonperfectionists. Journal of Counseling Psychology, 51(2), 192-200.

38.

Hamachek, D.E. (1978). Psychodynamics of normal and neurotic perfectionism. Psychology. Journal of Human Behavior, 15, 27-33.

39.

Hardt, J., Buchwald, D., Wilks, D., Sharpe, M., Nix, W.A., & Egle, U.T. (2001). Health-related quality of life in patients with chronic fatigue syndrome:An international study, Journal of Psychosomatic Research, 51(2), 431–434.

40.

Hewitt, P.L., Caelian, C.F., Flett, G.L., Sherry, S.B., Collins, L., & Flynn, C.A. (2002). Perfectionism in children: associations with depression, anxiety, and anger, Personality and Individual Differences, 32(6), 1049-61.

41.

Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60(3), 456.

42.

Hewitt, P.L., & Flett, G.L. (1993). Dimensions of perfectionism, daily stress, and depression: A test of the specific vulnerability hypothesis. Journal of Abnormal Psychology, 102(1), 58-65.

43.

Jason, L. A., Richman, J. A., Rademaker, A. W., Jordan, K. M., Plioplys, A. V., Taylor, R. R., et al. (1999). A community-based study of chronic fatigue syndrome. Archives of Internal Medicine, 159(18), 2129.

44.

Jiang, N., Sato, T., Hara, T., Takedomi, Y., Ozaki, I., Yamada, S. (2003). Correlations between trait anxiety, personality and fatigue: study based on the Temperament and Character Inventory. Journal of Psychosomatic Research, 55(6), 493-500.

45.

Kawamura, K.Y., Hunt, S.L., Frost, R.O., & DiBartolo, P.M. (2001). Perfectionism, Anxiety, and Depression: Are the Relationships Independent?. Cognitive Therapy and Research, 25(3), 291-301.

46.

Kempke, S., Van Houdenhove, B., Luyten, P., Goossens, L., Bekaert, P., & Van Wambeke, P. (2011). Unraveling the role of perfectionism in chronic fatigue syndrome: Is there a distinction between adaptive and maladaptive perfectionism? Psychiatry Research, 186(2), 373-377.

47.

Kim, C.H., Shin, H.C., & Won, C.W. (2005). Prevalence of chronic fatigue and chronic fatigue syndrome in Korea: Community-based primary care study. Journal of Korean Medical Sciences, 20, 529-34.

48.

Kirk, J., Douglass, R., Nelson, E., Jaffe, J., Lopez, A., Ohler, J., Blanchard, C., Chapman, R., McHugo, G., Stone, K. (1990). Chief complaint of fatigue:A prospective study. The Journal of Family Practice, 30(1), 33-39.

49.

Kroenke, K., Wood, D. R., Mangelsdorff, A. D., Meier, N. J., & Powell, J. B. (1988). Chronic fatigue in primary care. The Journal of the American Medical Association, 260(7), 929-934.

50.

Lane, T. J., Manu, P., & Matthews, D. A. (1991). Depression and somatization in the chronic fatigue syndrome. The American Journal of Medicine, 91(4), 335-344.

51.

Lewis, G., & Wessely, S. (1992). The epidemiology of fatigue: More questions than answers. Journal of Epidemiology and Community Health, 46(2), 92.

52.

Loge, J. H., Ekeberg, & Kaasa, S. (1998). Fatigue in the general Norwegian population: Normative data and associations. Journal of Psychosomatic Research, 45, 53-65.

53.

Luyten, P., Kempke, S., Peter Van Wambeke, P., Claes, S., Blatt, S.J., & Van Houdenhove, B. (2011). Self-Critical Perfectionism, Stress Generation, and Stress Sensitivity in Patients with Chronic Fatigue Syndrome: Relationship with Severity of Depression, Psychiatry, 74(1), 21-30.

54.

Luyten, P., Van Houdenhove, B., Cosyns, N., & Van den Broeck, A. (2006). Are patients with chronic fatigue syndrome perfectionistic—or were they? A case-control study, Personality and Individual Differences, 40(7), 1473–1483

55.

Magnusson, A. E., Nias, D., & White, P. (1996). Is perfectionism associated with fatigue? Journal of Psychosomatic Research, 41(4), 377-383.

56.

Matthews, D.A., Manus, P., Lane, T.J. (1991). Evaluation and management of patients with chronic fatigue. American Journal of Medical Science, 302, 269-77.

57.

Moss-Morris, R. Spence, M.J., & Hou, R. (2011). The pathway from glandular fever to chronic syndrome: can the cognitive behavioral model provide the map? Psychological Medicine, 41, 1099-1107.

58.

Piper, B. (1989). Fatigue: Current bases for practice. S. Funk, E. Tournquist, M. Champagne, L. Copp, R. Wiese (Eds.), Key Aspects of Comfort: Management of Pain, Fatigue, and Nausea (pp. 187-198). New York: Springer.

59.

Pollack, M.H.(2005). Comorbid anxiety and depression. The Journal of Clinical Psychiatry, 66(s8), 22-29.

60.

Prins, J.B., Bleijenberg, G., Bazelmans, E., Elving, L.D., de Boo, T.M., Severens, J.L., Van der Wilt, G.J., Spinhoven, P., Van der Meer, J.W.M. (2001). Cognitive behaviour therapy for chronic fatigue syndrome: a multicentre randomised controlled trial, Lancet, 357, 841-847.

61.

Rice, K. G., Ashby, J. S., & Slaney, R. B. (1998). Self-esteem as a mediator between perfectionism and depression: A structural equations analysis. Journal of Counseling Psychology, 45(3), 304.

62.

Rimes, K.A., & Chalder, T. (2005). Treatments for chronic fatigue syndrome, Occupational Medicine, 55, 32-39.

63.

Saboonchi, F., & Lundh, L. (1997). Perfectionism, self-consciousness and anxiety, Personality and Individual Differences, 22(6), 921–928.

64.

Shafran, R., Cooper, Z., Fairburn, C.G. (2002). Clinical perfectionism: a cognitive-behavioral analysis. Behavior Research and Therapy, 40, 773-791.

65.

Sharpe, M., Hawton, K., Simkin, S., Surawy, C., Hackmann, A., Klimes, I., Peto, T., Warrell, D., Seagroatt, V. (1996). Cognitive behaviour therapy for the chronic fatigue syndrome: a randomized controlled trial. British Medical Journal, 312(7022), 22-6.

66.

Short, K., McCabe, M., & Tooley, G. (2002). Cognitive functioning in chronic fatigue syndrome and the role of depression, anxiety, and fatigue. Journal of Psychosomatic Research, 52(6), 475-83.

67.

Sumi, K., & Kanda, K. (2002). Relationship between neurotic perfectionism, depression, anxiety, and psychosomatic symptoms: a prospective study among Japanese men, Personality and Individual Differences, 32(5), 817–826.

68.

Taillefer, S.S., Kirmayer, L.J., Robbins, J.M., Lasry, J.C. (2002). Psychological correlates of functional status in chronic fatigue syndrome. Journal of Psychosomatic Research, 53(6), 1097-106.

69.

Vercoulen, J. H. M. M., Swanink, C., Fennis, J. F. M., Galama, J., van der Meer, J. W. M., & Bleijenberg, G. (1994). Dimensional assessment of chronic fatigue syndrome. Journal of Psychosomatic Research, 38(5), 383-392.

70.

Walker, K., McGown, A., Jantos, M., & Anson, J.(1997). Fatigue, depression, and quality of life in HIV-positive men. Journal of Psychosocial Nursing and Mental Health Services 35(9), 32-40.

71.

Wessely, S., Chalder, T., Hirsch, S., Wallace, P., Wright, D.(1996). Psychological symptoms, somatic symptoms, and psychiatric disorder in chronic fatigue and chronic fatigue syndrome: a prospective study in the primary care setting. American Journal of Psychiatry, 153(8), 1050-9.

72.

White, C., & Schweitzer, R. (2000). The role of personality in the development and perpetuation of chronic fatigue syndrome. Journal of Psychosomatic Research, 48, 515-524.

한국심리학회지: 건강